After thorough debridement and Clindamycin soaking, a 2 mm pilot drill, which is used to initiate osteotomy in the palatal wall for 20 mm, has distance from the Incisive Canal (Fig.3 red dashed line).

Then the initial osteotomy is moved more palatal by using a Lindamann bur, followed by 2.5 mm reamer at 17 mm (leaning as palatal as possible; underprep).  For the same manner (pressure exerted to prevent buccally drifting), 4.5x20 mm tap and implant (Fig.4 I, >56 Ncm)) are placed so that the implant and abutment are palatally positioned.

Rebuild Buccal Plate Last Next

Xin Wei, DDS, PhD, MS 1st edition 08/11/2015, last revision 05/28/2018